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Wiki PLA vs CPT

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ca_cpc

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Does anyone have any guidance on billing PLA vs CPT codes? I ask in general, but specifically we're trying to sort out whether we should be billing 87637 or 0241U for our COVID/RSV/Flu A&B in-house testing. I'm unfamiliar with PLA codes, and am finding the available guidance unclear. I realize PLA are supposed to take precedence over CPT, but since both codes were implemented at the same time I have to wonder if there's a reason for the 87637 and therefore instances when it should be billed rather than the 0241U? I'm hoping there are some easy answers I'm just missing - since this is new to me I want to sure I'm doing things correctly.
I don't know if it makes a difference, but we're a small FQHC and generally only run a handful of these every week.
Thanks so much!
 
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ca_cpc said:
Does anyone have any guidance on billing PLA vs CPT codes? I ask in general, but specifically we're trying to sort out whether we should be billing 87637 or 0241U for our COVID/RSV/Flu A&B in-house testing. I'm unfamiliar with PLA codes, and am finding the available guidance unclear. I realize PLA are supposed to take precedence over CPT, but since both codes were implemented at the same time I have to wonder if there's a reason for the 87637 and therefore instances when it should be billed rather than the 0241U? I'm hoping there are some easy answers I'm just missing - since this is new to me I want to sure I'm doing things correctly.
I don't know if it makes a difference, but we're a small FQHC and generally only run a handful of these eve
ca_cpc said:
Does anyone have any guidance on billing PLA vs CPT codes? I ask in general, but specifically we're trying to sort out whether we should be billing 87637 or 0241U for our COVID/RSV/Flu A&B in-house testing. I'm unfamiliar with PLA codes, and am finding the available guidance unclear. I realize PLA are supposed to take precedence over CPT, but since both codes were implemented at the same time I have to wonder if there's a reason for the 87637 and therefore instances when it should be billed rather than the 0241U? I'm hoping there are some easy answers I'm just missing - since this is new to me I want to sure I'm doing things correctly.
I don't know if it makes a difference, but we're a small FQHC and generally only run a handful of these every week.
Thanks so much!
Click to expand...
We are an FQHC and wanted to check how much did you enter as a billed amount? Hope you can respond TIA
Click to expand...
 
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Sorry I didn't see this sooner! Do you mean our charge amount? We're billing the 87637 at $250. I'm not sure what our reimbursement rates are, but I can find out if you need them.
 
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